CIHM 

Microfiche 

Series 

(IMonographs) 


ICMH 

Collection  de 

microfiches 

(monographies) 


Canadian  Institute  for  Historical  Microrsproductions  /  Institut  Canadian  da  microroproductions  historiquas 


Technical  and  Bibliographic  Notes  /  Notes  techniques  et  WWtographlques 


The  Institute  has  attempted  to  obtain  the  best  original 
copy  available  for  filming.  Features  of  this  copy  which 
may  b«  UMiographically  unique,  which  may  alter  any  of 
th«  images  in  the  reproduction,  or  which  may 
significantly  change  the  usual  method  of  filming  art 
chedcad  tMiowi 

Coloured  covers  / 
Coir/Mtiiredt  couteur 

□ Covers  damaged  / 
Couverttire  endommagte 

□ Covers  restored  and/or  laminated  / 
Couverture  resttnffto  et^  pelHeuiie 

I       Cover  title  missing  /  Le  titre  de  couverture  manque 

I      Colound  maps/ Cartes  gtegraphiques  en  couieur 

□ Coiourad  ink  (i.e.  other  than  blue  or  Made)  / 
BKf*  de  oouleur  (Le.  autre  que  Ueue  ou  noire) 

□ Coloured  plates  and/or  illustrations  / 
planchM  etANi  illustrations  en  Muleur 

□ Bow>d  with  other  material  / 
ReM  avec  d'autree  documents 

□ Only  edition  available/ 
SeuleMitiondi8pon«)le 

□ light  bin(fing  may  cause  shadows  or  distortion  aiwig 
interior  margin  /  La  reliure  serr^e  peut  causer  de 
I'ombre  ou  de  la  distorsion  le  long  de  la  marge 
mieneure. 

□ Blanit  leaves  added  during  restorations  may  appear 
wiMn  ttie  text.  Whenever  possible,  these  have  been 
omitted  from  filming  / 11  se  peut  que  certaines  pages 
blanches  ajout^es  iors  d'une  restauration 
^)pafldnent  dans  le  texte,  mais,  lorsque  cela  itaR 
pMSlbie.  eat        n'ont  pas  «ti  f  Umtes. 

□ AdiMiMial  comments/ 
Commentaires  suppKmentairts: 


L'institut  a  microfilm^  le  nwilleur  exemplaire  qu'il  lui  a 
posdbit  de  se  pfocwtr.  Let  dMaNt  de  eel  tMm- 
plaire  qui  sont  peut-6tre  uniques  du  point  de  vue  bibll- 
ographique,  qui  peuvent  modifier  une  image  reproduite, 
ou  qui  peuvent  exigtr  unt  mocMiettion  dant  It  mMio* 
dt  nomitit  dt  flmtgt  torn  indlquit  d-dtatout. 

I    I  Coloured  pages/ Pages dtcouitur 

I    I  Pages  damaged/ Pages  endomnwgtet 


Pages  restored  and/or  laminated  / 
P^ges  restaurtes  et/ou  pelUcultes 


Pages  discoloured,  stained  or  foxed  / 
Pages  d^colortes,  tachet^es  ou  piqutes 


I    I  Paget  dtltehtd/Ptgttdiltchttt 

f/l  Showthrough /Transpartnet 


Quality  of  print  varies  / 
Quality  inigale  de  Hmpression 


Includes  supplementary  material  / 
Comprend  du  matMd  suppMmentair^ 


□ Pages  wholly  or  partially  obscured  t>v  rrata  slips, 
tissues,  etc.,  have  been  relRmed  to  ens*.  » the  best 
possible  image  /  Les  pages  totalement  ou 
pattiellement  obscurcies  par  un  feuillet  d'errata.  unt 
pelure,  etc..  ont  M  fftniet  k  nomma  dt  ftfon  k 
oMtnir  It  mtMtyrt  imtgt  potaBrit. 

□ Opposing  pages  with  varying  colouration  or 
discotourations  are  filmed  twice  to  ensure  the  best 
possible  image  /  Les  pages  s'opposant  ayant  des 
colorations  variablet  ou  dtt  dteoiorttkHW  tont 
rihn«es  deux  foto  tfebtenir  It  mtilMiPt  kntgt 
pMslite. 


This  Ittm  la  filmed  at  the  reduction  ratio  checked  below  / 

C«  document  est  (ilmi  au  taux  de  rMuction  indiqu4  ci-deaaoua. 


10x 


14x 


18x 


22x 


26x 


30x 


I   I   I   I   I   I  I 


12x 


20x 


24x 


28x 


32x 


Th«  fUmad  h«r«  has  bmm 
to  t>m  StfMrosity  of: 

Oiler  Library, 
McGill  UnivMtity. 


Th«  imagM  appaaring  hara  ara  tha  baat  quality 
poaaibia  eonaidaring  tha  condition  and  iagibility 
of  tha  original  copy  and  in  Icaaping  wMi  tfw 


Original  copiaa  in  printad 
baginning  with  tha  ftont  i 
tha  iaat  paga  with  a  printad  or  illuatratad  impr 
aion,  or  tha  bacic  eovar  whan  appropriata.  All 
othor  original  eopiaa  ara  fiimad  baginning  on  Hw 
firat  paga  with  a  printad  or  iliuatratad  imprao- 
and  andkig  on  tha  iaat  paga  with  a  primad 


Tha  iaat  racordad  frama  on  aach  microficha 
shall  contain  tha  symbol       (moaning  "CON> 
TINUEO").  or  tho  symbol  y  (moaning  "ENO"). 


IMapa.  piatas.  charts,  ate,  may  ba  fiimad  at 
diffarant  raduction  ratios.  Thosa  too  larga  to  ba 
antiraly  includad  in  ono  aapoaura  ara  fiimad 
baginning  in  tha  uppar  laft  hand  comof >  laft  to 
right  and  top  to  bottom,  as  many  framas  as 
raquirad.  Tha  following  diagrama  iliuatrata  tha 


L'axampiaira  fMm4  fut  rapro^ih 
ganaroaiia  oa. 

0*l«r  Library, 
McGill  Univwdty, 


grieaAli 


Las  imagas  suivantas  ont  M  raproduitss  avac  la 
plus  grand  soin,  compta  tanu  da  la  condition  at 
da  la  nattat«  da  I'axampiaira  flton*.  at  an 
eonf ormM  avac  laa  eondMona  du  contrat  da 


Lao  aaamplairaa  originaux  dont  la  couvartura  an 
poplar  aat  bnprim^a  sont  filmte  an  comman^nt 
par  la  pramiar  plat  at  an  tarminant  soit  par  la 
damiAra  paga  qui  comporta  una  amprainta 
dlmprassion  ou  d'illustration,  aoit  par  lo  saeond 
plat,  aalon  la  eaa.  Toua  laa  autraa  axamplairas 
origlnaux  sont  fllmte  an  commandant  par  la 
pramiira  paga  qui  comporta  una  amprainta 
d'impraaaion  ou  d'iNuatration  at  an  tarminant  par 


Un  daa  symbolaa  suivants  apparattra  aur  la 
damiira  imaga  da  chaqua  microficha.  salon  la 
eaa:  la  symbolo       signifia  "A  SUIVRE".  la 
aynasBW  w  aigmio  rtia  . 


Las  cartas,  pianchas.  tablaaux.  ate.  pauvant  Atra 
fiimis  i  daa  taux  da  riduction  diffirants. 
Loraqua  la  documant  aat  trap  grand  pour  4tro 
raproidult  an  un  aaul  oNofi*.  H  aat  fRmA  i  partir 
da  I'angia  supiriaur  gaucha.  da  gauche  i  drolta. 
at  da  haut  an  baa.  an  pranant  la  nombra 
d'imagaa  nicaaaaira.  La 
iMuatrant  la  mithoda 


1 

2 

3 

4 

5 

6 

A  FATAL  CASK  OV  BLAtXVIIIYOOSlS. 
t,  WmMMm  J.  Bmwnum,,  M J>,  LLJ>,  airf  L.  I.  iij>^ 


MM.  M.,  an  Italian,  twenty-five  year,  of  age,  came  to  our 
clinic  on  Aug.  «,  1910,  compUining  of  an  .rupUon  on  tht 
•  no»e  and  side  of  the  fact.   TlmkiBff  the  eMt  looktd  Hlw 
«>»MtoByrc€«.  wt  admittwl  him  into  our  wards  for  observation 

HnrosT.  Hk  pamts  are  living  and  healthy;  his  brotbert  and 
sisters  are  also  healthy.    When  he  came  to  this  countiy  two  ,mn 

I!L" *°  months\r 
Heha.  hmn  wvMag  m  •  rdhray  nawy,  but  lately  has  lived  in  Mon- 

tl.*t°ll."ri  • '"^'''TJ"  "."^  th.  day  after  «baiMion,  we  found 
2^  addition  o  the  erupti*  «  fch  ft«,  t|«.  wm  .  .i„u.  di^ 

«Ki  of  the  ngfat  cUvicle;  also  a  fluctuating  ,^  Umg  over  the  iec«d 
lumbar  vertebra.   The  growth  on  the  f^Teo,  ^^  upvlrZ^ 

canthM  of  fte  eye,  and  wa.  continuous  with  a  fungating  nowth 
below  the  nght  lower  eyelid,  the  size  of  a  twenty-five-c«,lSi. 
mparts,  over  the  noM.  wa.  dceratmg  «,d  dLha^g^  ^^SJ 
^  spo^,  evid«c«l  by  which  .howed  healinV^^in^^le 

STJ^^i  "M?  covered  the  ulceration  and  in  the  tghborhooHf 
the  growth,  on  the  right  cheek,  were  eome  nodule,  of  •  mfcUAerf^ 
Thich  had  not  yet  ulcerated.  naatMb  color 

Portkm  of  tinue  were  removed  and  sent  to  the  -i 
«jh«j»  w«,  deo  nu^  ,rom  pus  taken  f rT^  ^tL* tS^^t 
*nd  that  coming  from  the  sinus  at  the  upper  cad  of  tht  rt^u» 
j^examination  of  the  h««t  «.d  l^^^Tm^^J^Zti^ 
«Kll*.iiriB.w«d»fb«BdtobeBonn5:       "•^  «* 

examination,  both  culture,  and  wetieii..  havhw 

Jor^S^;™^ 

t«ipe-«ta«  row  to  lOf  F.  and  a  dull  are.  aiJ^ml  „!!;  frif^ 
of  the  right  lung  with  diminished  hZh  Z^Ttn^^l^.'Z 
Wuj^t  no  hl^g  breathing.  There  was  Z'iE::^^1f 
«  (Be  ligM  tide,  its  aepirating  needle  wa.  tiimmt  ti^  j 
fc"*  Uoedr  frid  mi.ti.  l  -^^TT^  wa.  uirwt  mte  th.  duU  area, 
—y  oiooay  MM  Hndted,  whfeh  prodnoad  no  eakona  of  the 


fl 


ORIGINAL  COBflftJNICATIONS 


blwtonyew.  Hit  ^vtwH  wUdi  •!  thk  timt  wm  vtry  prafuM,  aIm 
TMiM  bo  •fidtnet  of  UMtoaTcoaii  oa  txambatioB. 

His  condition  growing  worse,  to  our  ■orruw,  he  left  the  Hoapltel 
on  October  8th,  promuing  to  report  his  condHioB  from  time  to  time. 
We  hMund  Botteff  Iran  Un  wifl  Oelobtr  Mti^  whn  ht  again  appUed 
for  admiifion. 

On  again  examining  him,  we  found  that  the  lesion  on  hi*  face  had 
increased  in  size  and  new  spots  had  appeared  below  the  oM  obm. 
kft  lung  continued  to  be  clear  and  healthy,  but  his  right  lung  was 
•mnewhat  worse  than  before.  The  sinus  over  the  upper  part  of  the 
sternum  wns  much  the  same,  but  the  fluctuating  swelling  over  his  lum- 
bar spina  had  increased  in  un  and  was  red  and  shiny.  A  red,  swolltn 
•mhndnnMftndoTvrOierii^wrirt.  The  pube  was  now  90  to  IM, 
respirations  S5  to  80  and  the  temperature,  98°  to  101°  F. 

The  tumor  in  the  lumbar  region  was  opened  and  much  pus  evacu- 
ated; the  bom  waa  net  iofotni,  Oalhwm  Aannd  Uaatonyeom. 
He  had  become  very  emaciated  and  tre  .tment  with  iodide  of  potasaitm 
was  of  no  avail,  even  in  doses  of  forty  grains  three  times  daily. 

In  November,  the  condition  of  the  lesions  was  as  follows : 

"The  large  growth  on  the  face  now  involves  the  upper  and  lower 
eyelids  of  both  eyes  and  the  tissues  over  both  malar  bones  and  nose. 
The  edges  of  the  ulcerated  areas  are  sharply  defined,  raised  and 
irregular  in  outline  and  covered  by  a  dry,  brown  enut.  When  the 
ennt  ie  remwcd  tile  edgaa  <rf  At  idetn  Men  to  be  tolndated  and  deeply 
fissured.  The  ulcer  over  the  malar  region  extends  to  the  bone.  The 
left  lower  eyelid  is  much  retracted,  exposing  the  eydball.  The  diaeaae 
has  now  affected  the  left  noetrO  and  the  left  vpptr  Up  and  kaa 
extended  to  the  adjacent  mucous  membrane.  The  lesions  on  the  lip 
are,  as  yet,  quite  superficial.  New  areas  are  beginning  to  involve  the 
chin  and  under  the  chin  is  a  new  lesion  about  1  cm.  in  diameter. 

"On  the  back  of  the  neck,  just  below  the  lower  margin  of  the  hair, 
thtre  are  several  niperfieial,  red^th  spots  of  disease,  sharply  out- 
lined. The  sinus  at  the  sternal  end  of  the  clavicle  has  increased  in 
size  and  a  new  sinus  has  opoied  above  the  old  one,  which  also  leads 
to  a  cavity  in  the  tteraal  end  of  the  davfall.  Botii  ■innaea  <&- 
charge  pus  freely. 

"Over  the  posterior  border  of  the  deltoid  muscle,  near  the  axillary 
fold,  an  ulcerated  area,  S  cm.  in  diameter,  has  appeared,  with  raised 
undermined  edges.  Over  the  upper  lumbar  region  where  the  abscess 
WM  opened,  there  is  a  deep  ulcer  discharging  pus;  there  is  alstf  an 


A  lATAL  CASB  09  JttjmmfOOm  0 

«la«r  M  mA  hiilluuh  aad  ever  tht  right  gnat  trodMater.  There 
Mt  •nrasw  in  front  of  the  left  tibia,  on  the  inner  lurface  of  the  lower 
Md  of  tht  right  humcnu  and  over  tha  middle  of  the  right  tarw^ 
■ttatarMd  articulation,  all  kadfaig  dowB  to  iBmml  boM. 

"Before  death,  a  Urge  fluctuating  .welling  appeared  in  the  left 
popliteal  epaet  aad  right  mguiaal  region.  The  condition  of  the  right 
MBg  became  worw  until  tht  whole  organ  wai  involved. 

"Bjr  tht  btgiaaiiig  of  DMMibtr,  the  patient  became  much  more 
•marnttd.  p«Im  efttiwJ  to  bt  rapid,  high  temperature,  pre- 
vailed and  the  patient  graduaUy  grew  weaker  and  died  on  E 
trth,  about  nine  montbt  from  tht  first  onstt  of  tbt  distatt." 


MONTREAL  GENERAL  HOSPITAL. 


UuCMia  Awu  tit  Sa*(4 


4 


ORIGINAL  COMMUNICATIONS 


The  autofwjr  rtport  •ubjointd  herewith  hu  been  furniihed  me  Ij 
Dr.  !<.  J.  Rhea,  Director  of  the  Pathological  Laboratory  of  the 
Montreal  General  Hospital,  mmI  to  wimm  I  Ml  sIm  WlklMl  for  ^kt 
excellent  pbotomicn^praphe. 

AvTonv. 

(10— tSl.) 

The  chief  interest  in  this  case,  from  the  pathological  viewpoint, 
i(t  the  wi«le  diiitribution  of  the  lesion*,  the  character  and  extent  of 
ttwMc  lesion*  and  the  baettriological  study.  The  following  is  a  brief 
extract  of  the  poet-nortcm  fadincs.  No  reference  is  made  to  the 
cutamou.H  lesions,  as  these  kvn  him  dtMrftad  fa  the  clinical  pmcn- 

tation  of  thr  cuse. 

Pr»iT<>vr»i.  Cavitv.  The  pnrlifal  peritoneum,  jtrrnt  imirntiim.  (TBitro-hcpntlr 
oiiH-nfuni,  iiihI  thr  in|»iilr<i  of  the  IIvit  and  s\,\tTn,  nrr  thirkly  mmIiiI  with  Mniill. 
discrelp,  \rlliiuish-Hhitr,  ftrm  arena,  whU'h  \iiry  in  ^lx^•  from  I  mm.  to  3  or  4 
mm.  ill  (liiiini  trr.  They  nrr  nimt  numerous  in  th<-  (freaf  omentum,  the  pouch  of 
Doufrlas  mid  in  thr  rrn-sses  on  earh  side  of  the  lower  lumbar  vertrbre.  The 
inc»ent«  rlr  lymph  nodes  nn-  sllnhtly  rnlarifrd.  On  swtlon,  they  show  »oft,  pinkish 
pulp  in  wMch  are  numerous  small,  rounded,  soft,  yellowish  areas. 

PurSAL  CsriTiM.  Doth  plrural  ravitirit  show  flbrinous  adhesions  between  the 
parietal  and  vtseeral  toyew-  The  ImH  aiMl  pericardtiiw  riMw  no  cridsiwe  af 
UaatoNqmisis. 

Lvxes.  RigM,  MO  gms.|  left,  MO  gni  .  The  right  vinrrral  pleura  is  thirlcened, 
Tsryinf  from  9  to  i  nna.  in  Hiekassa,  ii  firm,  opaque  and  tense,  especially  over 
the  lower  lobfc  Tks  lung  tissw  eats  icaAljr,  luu  s  fleshy  appearance  and  Nhows 
diffase  (ons^dation.  Tiw  nmrter  part  of  the  right  lung  consists  of  grsyiih  areas 
of  different  slars,  Utwsaa  wMek  tht  tiuae  i*  pak  rsd.  Tlw  lower  Ma  is  mch 
smaHer  than  norauil.  The  irienra  corering  this  Me  aad  that  hetweea  the  ^per 
and  lower  lobes  arerages  »  to  A  mm,  fai  tWrkaess  and  IhroMghiHil.  these  are 
numemiis  sharply  outlined,  freneralljr  oral,  jfcMowlsh  aseas  of  softealBg.  whM 
vary  from  1  mm.  to  1  cm.  in  length. 

The  bronchi  are  wide  and  are  generally  surrounded  by  ■  tone  of  pale,  wWIS, 
gli»tenlng,  Ann  tissue.  The  rut  surface  of  the  lung  shows  several  hoa^cairibed 
areas,  in  which  are  numeroiis  cavities  varying  from  •  to  t  naa.  hi  dloaieler.  T^Hf 
contain  a  greenish-gray,  puriform  material. 

-  The  left  lung  is  larger  than  the  right  and  its  pleura  contains  Jl  lhialsh  wMlS. 
slightly  elevated  areas,  which  vary  from  1  to  4  mm.  In  rfiameter  and  are  apparently 
in  the  underlying  lung  ti-ssue.  The  cut  surface  is  darlc  red  and  shows  very  many 
discrete  and  confluent  yellowish-white  areas,  which  vary  from  1  to  A  nmi.  la 
diameter.  These  areas  contain  thicic,  yellowish,  puriform  material.  The  hmMi 
do  not  show  the  peribroncl;lal  thickening  present  in  the  right  lung. 

Snnnr.  Weight,  930  gms.  t*.-.  t.  .  . 

nodaie  seen  la  the  capsule. 

^"N^        i'as.  The  only  gross  lesions  are  seen  In  the  capsule,  where 
ttereare  maMroas  yellowish  areas  similar  to  those  seen  elsewhere  in  the  peri- 

Kianws.  We^ht.  990  gms.  SMning  through  the  capsule  are  several  sharply 
eatttied.  small,  raokl  to  aval.  y^MMMridte  aieaB.  These  are  scattstcd  over  tte 


A  FATAL  CASB  OP  BLAlTOICyOOUS 


  .     ^     -.— -T  7-*       '^'■♦•«      nuiniToui  rcUowtob-whlu,  Mft 

g"*  '"jL*!  ?**  *  *  ■■•  "  "MiBntw.  Thejr  contbt  of  puriform  iMtoriaL 
™»  am  mmm  mmmnm  in  IIm  cortex  tkaa  to  tht  oMdnlU. 

marnMropIt  Mm 


..  u  ..^^^^f^  ^?*'  *!  — '■^_*!— P*       -wplMifM,  T  cm.  from 

Jwt  bMiMtk  tin  OMMOW  nwmbraiie.  ~— t         »  owMiar, 


Omk  v«  SmiM.  The  right  darkle,  ri|rht  attow  JctaL  Ml  IW«  Mi  bfl  tmtma. 
metsUnrI  bone*  were  rcmoT«d  and  later  examtecd.  The  ctov  Jital  MilSfe 

were  Mwed  tungitudinalljr  with  a  ImumI  taw. 

*  «•'•»•«•••  «•  thkkcnedi  t4  IkM 

the  artlrular  surface  it  I.  9.8  cm.  thicli,  the  articular  surface  b  Doraal.  ■ 
from  the  articular  surface  there  i>  an  oval  hole.  l.I  cm.  hmg  and  •  MB.  bM&  k 
the  bone,  which  communicates  with  the  medullary  cavity    The  mlntji  mrHm 
w'l^''  »»>c         1  rni.  is  roughened,  due  to  narrow,  caamnl. 

catinf  bands  of  bony  :l«ue.  (.etween  which  are  depressed,  elastic,  pak^  cUstenlM 
turn,  apparently  i;..  periosteum,  beneath  which  the  bone  has  been  destroyed 

:  "^"f  ^r.".  t»»  •*»».  described 

riiMmiiMcatce.  have  lost  their  periosteum.  Their  external  surfaces  are  irranular. 
""  "•'•■■■■'I  *•»«■  there  U  a  thick,  purulent  fluid. 

f"*^  longitudinally,  ju«t  to  one  side  of  an  opening  In 

11»  MAUIWT  cavity,  bennth  the  bone  sinus  shows  a  marked  change.  Through- 
out w'JS.^*3Jr*.l2  *•  >'»»''''»^*Wt«.  fT^nSlar  materfal. 
ttane  to  the  mcdaUaijr  csfttar  mdwllr  renii  toto  a  - 
beyond  which  the  B«Slto  bWSTwJc  •*■■»•«  tUM^ 

FKMii.  Ri  iow  JoixT  A»o  Uwra.  TiM  bMW  mm  tmmi  thnnwh  kmgitudinaUr 
On  the  inner  aspect  of  the  lower  end  of  tte  IMMIW  tfem  to«l?«iSfr  a^l  a  ^ 
by  8.1  cm.,  throughout  which  the  bone  I.  JhSnt^hSi^-SebT^^ 
whrn  m^sericd  Info  the  skin  sinus.  tM.  potat,  Ifc.  ►  ^  ttto  o«bK 
•oft,  pale  grayish-red  and  bathed  in  a  thick  puriform  ms  I.  The  iwdertvln. 
medulla  shows  an  area.  4  cm.  long,  throughout  whi.  h  it  a  s  .  srwinter,  >ra^ 
white  tissue.  The  synovial  surface  of  the  elbow  )<ies  not  .jntw  to  be 
and  the  cavity  is  free  from  exudate.  ^ 

The  brain  show*  no  macroscopical  ieshma.  The  uOddle  can  Md  *- — ■ 


AVATOmCal.  DuoKotn. 
Generalized  bUutomycofia. 

Bbstofl^jreodi  of  the  akfai,  bonce,  peritmeum,  lymph  nodes,  pleura, 
and  lungs.  r  . 

Generalized  blastomycosis  of  the  kidneys. 
Chronic  obKterative  pleantit. 

BUstomycosis  of  the  left  adrenal,  prostate  and  oesophagus. 
MienMcopically,  the  lesions  in  the  varioua  organs  show  the  Mne 
gmtni  proeaH  ud       iBaatmtai  fa  tiw  plwIoiBierognpfaa  atid 


6 


ORIGINAL  COMMUNICATIONS 


drawings.  There  is  necrosis  of  the  tissues,  cellular  infiltration,  giant 
cdls  and  many  spheres  with  definite  encapsulating  membranes.  The 
organisms  are  very  numerous  and  are  seen  both  eztrscellalarly  and 
within  the  cytoplaim  of  the  giant  cells.  The  number  of  the  giant 
cells  varies ;  some  sections  contain  only  one,  others  ei^t  or  more.  Tlw 
organisms  appear  in  the  tissues  as  round  bodies  which  have  a  sharply 
outlined,  limiting  capsule.  They  show  various  stages  of  budding. 
No  mycdia,  or  s]dieres  containing  spores,  as  seen  in  d«Buitit»  eoe» 
cidioides,  were  found  in  the  tissue. 

The  organism  was  recovered  in  cultures  several  times  from  the 
subentaneoos  abrasions  during  life  and  from  several  vi  the  lesions 
at  post-mortem  examination.  It  grows  best  on  sugar-containing 
media,  beneath  rather  than  within  the  thermostat.  In  five  days,  small 
coloni'^s,  similar  to  those  of  Oidium  lactis,  are  visible.  Microscopic- 
ally, they  consist  of  branching  mycdia.  The  growth  bcemnes  incor- 
porated with  the  superiieial  layers  of  the  media.  The  lesions  pro- 
dnced  in  nice  are  weD  shewn  in  the  gross  specima. 


ATE  XI.I.— To  IlliiarotP  Article  by  Francis  J.  SiiErHno,  M.D,  aiid  L.  I.  Rhba.  M.D. 


Fio.  I. 
OenersUxed  Blutomycosis. 
Lesioa  on  face. 


Fio.  2. 

tii'iieralizetl  Itlastoiiiynisis. 
CroM  section  of  mesenteric  lymph  node.   The  smmll,  inegularHshapedt 
datk  Meat  aie  mUtoy  alwcMWfc 


tm  JmnmAL  or  CmuxMn  Dmun,  HatmAet,  INL 


I'LATE  XI-11.— To  IlluKtrate  Artkle  b)  Fiavcu  J,  Shcvuiw,  MJJ,  and  U  1.  Rum,  M.D. 


Fm.  3. 

Oneralixed  BlastoroyoMis. 
I-ow  power— showing  single  miliary  abscess  of 
lymph  niMle.  A  large  giant  cell  containing  two 
offanlsms  is  seen  at  the  npper,  righthand  border 
of  the  abscess,  and  several  other  organisms  can 
be  seen  in  the  secttoo. 


Fio.  4. 

(icneriilizMl  Itlnstiiniyciixis. 
Ilifclier  powcT  tlmii  I''i(r.  %    Pcripherul  portion 
of  iniiiarA'  ah.sress  of  lyiii|>li  iio<lr.   Sere/al  organ- 
isms can  lie  seen. 


Fio.  4. 

GenerHlizeO  RluNtomyroKis. 
Ulaiit  cell  witii  one  organism  in  it.  Stained  with 
Miillory's  <'oimc'cti\e-tissiie  stain.     Tlie  narraw, 
white  /,(>i'c   Moiiiid  tile  eentnii,  circul.ir,  fUrker- 
stnining  iireii  is  tlie  periplieral  capsule. 


THt  Jomrat,  or  CirraxMHm  Dwuam,  November,  1911. 


